Several devices have been developed, for example, to tension cables in surgical applications. While such devices are useful, their application can be limited in minimally invasive surgical procedures, or in procedures where little space is provided at the operative site for positioning the device to apply a tensioning force. What is needed therefore, are instruments and methods having application in tensioning of elongate elements in minimally invasive surgical procedures and other procedures where space for positioning the instrument at the desired location may be obstructed.